Diabetes Care, Vol 21, Issue 6 925-929, Copyright © 1998 by American Diabetes Association
Evidence that the age at diagnosis of IDDM is genetically determined
D Fava, S Gardner, D Pyke and RD Leslie
Department of Diabetes and Metabolism, University of Bristol, U.K.
OBJECTIVE: The aim of this study was to determine the impact of genetic or
environmental factors on the age or time of onset of IDDM by studying pairs
of twins and siblings concordant for the disease. RESEARCH DESIGN AND
METHODS: From 404 twin pairs referred to a diabetic twin study, we selected
pairs concordant for IDDM: 1) 116 identical pairs with an index twin
diagnosed diabetic under age 60 years and 2) 12 identical and 12
nonidentical matched twin pairs. From 972 families referred to a
population-based diabetic family study, we selected sibling pairs with
IDDM: 33 pairs with an index case diagnosed diabetic under age 21 years.
Twin and sibling pairs were analyzed for intraclass correlations for age
and time of diagnosis. RESULTS: Of twins concordant for IDDM, the age at
diagnosis correlated 1) in 116 identical pairs (R = 0.94; P < 0.000001)
and 2) more closely in 12 identical twins (R = 0.96, P < 0.000001) than
12 nonidentical twins (R = 0.59, P = 0.046). Of 33 sibling pairs with IDDM,
the age, but not the time, of diagnosis was correlated (R = 0.53, P =
0.0016). CONCLUSIONS: Correlations within pairs of twins and siblings for
age, not time, at diagnosis suggest that much of the variability of the age
at diagnosis of IDDM is genetically determined.